My Child is a Picky Eater, but Could It Be Something More?

When does your child’s love of nothing but chicken nuggets and French fries become problematic? When does extremely picky eating turn into an eating disorder known as ARFID? And what can you as a parent do to help?

What is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is categorized as extremely picky eating. About 5% of children have ARFID. There are three subtypes:

• Restrictive: a lack of interest in food; lack of appetite
• Avoidant: avoidance of sensory stimulants such as color, texture, smell, taste, temperature; commonly associated with ADHD and autism spectrum disorder
• Aversive: characterized by fear of choking, gagging, vomiting, or having extreme gastroesophageal reflux symptoms when eating certain foods; usually caused by illness or choking episode in the past

How To Tell The Difference Between Picky Eating and ARFID In Children

Children with ARFID may have:

• Nutrient deficiencies or weight loss due to food avoidance
• Sensory issues causing them to avoid foods of a certain color, texture, etc.
• Aversions to entire food groups
• An extreme fear of choking or vomiting
• Preferences for foods cut up very small or pureed
• An extreme emotional response to trying new foods
• Difficulty engaging in social situations when safe foods are not available

How To Deal With Picky Eaters

1. Do not pressure or bribe your child into eating new foods. And don’t punish them for not trying new things.

When your child refuses food, you would do anything to get them to just eat.

Pressuring your child to eat new foods, and punishing them if they don’t, creates a negative association with new foods. Your child will develop even more anxiety around new foods and mealtime in general. The emotional strain may also hurt your relationship with your child.

Bribing your child with “anything they want” just to get them to eat limits their diet. It reinforces the idea that you’re okay with their limited set of food choices and the idea that their diet is sustainable. And you go from making a family dinner to being a short-order cook very quickly.

2. Talk to your child about why they don’t want to try certain foods.

Instead of focusing on what your child does or doesn’t eat, work to find out why they avoid certain foods. 

Once you figure that out, you (and an eating disorder professional) can develop a plan of action to break food fears and restrictions.

3. Start introducing new foods slowly.

Set up a positive, low-pressure environment outside of meal time where your child feels most at ease.

Offer your child a new fear food, but start with a less scary one in the beginning. This varies from person to person, as ARFID is a highly individual illness. This food may be a color that makes them uncomfortable or a food they believe they may choke on.

Ask them to take just one bite. Then, stay with your child. They may experience distress over having a new fear food, but once they realize nothing bad will happen from eating this food, eating it gets easier.

This process is called doing an exposure. Exposure therapy is effective at reducing all kinds of phobias. It’s usually done with trained professionals, especially if the child has a particularly severe food phobia.

Exposures can be trying on the child and the parent, but consistency is key. Keep trying.

4. Repeat exposures to new foods.

Having a new food once is not enough to change their perception of a food. Repeat exposures reinforce the fact that your child’s fear foods can’t hurt them.

With each exposure to a new food, offer a little more of it, until they no longer fear it. It may take 10 exposures before your child finally feels comfortable with the food.

Express how proud you are of them trying new foods, and consider implementing a non-food-based reward program for completed exposures.

Then, incorporate the new food into your family meal rotation and move onto the next fear food.

5. Seek professional help.

If you’ve tried everything you could and your child won’t budge or their physical health is suffering, it’s time for some professional intervention.

Seek out an eating disorder professional or treatment center who specializes in treating ARFID. Then, talk to your child about eating disorders and eating disorder treatment.

They may be unwilling to go, but you have to stand firm on this decision. Eating only chicken nuggets and french fries may not seem like a big deal now, but your child cannot develop physically, mentally, or emotionally if they’re held back by an eating disorder.

 

Featured image by Hannah Tasker, Unsplash